By Barbara Kunz, Ph.D., Staff Writer, myOptumHealth

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Arthritis is a disease that causes pain, swelling, stiffness, tenderness and redness in your joints. More than 100 different types of arthritis exist, affecting 36 million Americans. The most common is osteoarthritis, which happens when the cartilage that coats and protects the ends of your joints wears away.

Symptoms

You may have arthritis if you have stiffness in the morning that lasts 30 minutes or longer, persistent joint pain or tenderness, redness or warmth in a joint, weight loss, fever or weakness.

Be aware that herbs and supplements are not strictly regulated by the U.S. Food and Drug Administration. Do not assume if a product is considered "natural" that it is harmless. Many substances do not have sound science behind them to prove their safety or how well they work. Manufacturers may not be giving you what you think you are getting, or the way the substance is processed may be unhealthy or unsafe.

With many of these products, doctors do not know enough about them. Herbs and supplements may interact with prescription and over-the-counter medications or can worsen your health conditions. Consider that some supplements, such as vitamin A, may be unsafe when taken in megadoses.

It is strongly advised that you talk to your doctor before taking any supplement or herb. If you are taking an herb or supplement and notice any unusual symptoms, stop taking the substance immediately and talk to your doctor.

Supplement	Claims	Potential interactions and dangers	Possible side effects	What the experts say
Glucosamine	Halts, reverses or cures arthritis.	The purity of a glucosamine supplement cannot be guaranteed. Also, people with diabetes should not take glucosamine because it could interfere with the body's use of blood sugar. Glucosamine may interact with diuretics, blood sugar medications and other supplements.	No adverse side effects. However, it may cause insomnia, drowsiness, rash, headache and higher blood pressure.	Osteoarthritis does not have a cure. However, a well-designed study in the journal The Lancet found people who had mild to moderate knee arthritis who took glucosamine had, on average, 20 percent to 25 percent less pain and disability than people on a dummy pill. Research is ongoing. Talk to your doctor before taking glucosamine.
Shark cartilage	Relief of inflammation and pain.	People with a history of allergies to shark cartilage, chondroitin and glucosamine should not take this supplement. Shark cartilage may cause irregular heartbeats, lower blood sugar and slow the healing of wounds. Possible drug interactions include diuretics, some diabetes medications and some types of chemotherapy.	Shark cartilage can be well-tolerated with few side effects for up to 18 months. Most common side effect is a change in taste. Cartilage may cause stomach upset, nausea, vomiting, bloating, high blood sugar, constipation, slow healing of wounds, weakness, liver inflammation	No human studies have been done at this time. Check with your doctor.
SAM-e	Treatment of arthritis pain without the risk of bleeding as with aspirin.	People with bipolar depression should not take SAM-e because of a risk of bringing on manic episode. Don't use if severely depressed. SAM-e may also interact with some antidepressants. SAM-e is converted into homocysteine levels, which can raise the risk of heart disease. It may increase the risk of bleeding as well.	At high doses, you may have headache, insomnia and dizziness.	Don't take it. The benefits and long-term risks are unknown. Studies are scant and poorly done. Clinical trials are needed to find out if SAM-e is effective or dangerous. Do not self-medicate. See a doctor first.
Niacin	May improve flexibility, reduce inflammation and lessen the need for common pain drugs.	Can cause allergic reaction. Avoid if you have liver disease, abnormal heart rhythm, heart disease, blood clotting, bleeding disorders, asthma, anxiety, panic attacks, thyroid disorders, stomach ulcers, gout or diabetes.	Severe allergic reaction, skin flushing, rash, stomach upset, nausea, vomiting, diarrhea, liver disease and problems with thyroid function.	A small study has been done and is far from conclusive. Although niacin is a vitamin, it has definite risks. You should take niacin only with your doctor's permission. You will need regular checkups and blood tests to be sure the niacin isn't causing damage.

Acupuncture

One study found that acupuncture may help people with knee osteoarthritis. Those studied had intense knee pain and had never tried acupuncture. Those who got acupuncture had a 40 percent decrease in pain and a nearly 40 percent improvement in function.

Acupuncture is the practice of inserting thin needles into specific body points to improve health.

Lifestyle modifications

Eat a diet rich in fruits, vegetables and whole grains. Be sure to exercise. If your joints are inflamed, don't work out. Talk to your doctor about exercise before beginning a routine.

Conventional treatments

Acetaminophen (Tylenol) is often used for pain relief. Medications are available that can treat inflammation, swelling and joint pain. Talk to your doctor about how to best manage your pain.

SOURCES:

• National Center for Complementary and Alternative Medicine of the National Institutes of Health. What is CAM?
• National Center for Complementary and Alternative Medicine of the National Institutes of Health. Dietary and herbal supplements.
• National Center for Complementary and Alternative Medicine of the National Institutes of Health. Health information.